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Home My WebLink About2344 HOSP WAY; 226; CB970621; PermitL A ,ti l , t L I 1 A I I l ~ ~ r . L ... r ... ! l[~ ' JL . l' J ... .. , l L ~ +-f L l .. L lt ( L ~ A.' • ~ T [, 3 1 ? •t- i\' • A. • f AN, f • J:""r #· ' r t • V \ l ' w t-~ ll T L l E A , 1 F. A V • "-1/ .., y .J{ £ , q • l r .. • t-, I • .. I £ x•. • • #1 t, 2,, 4 \ ~ ' J. r. l, # ) re • )f ' 4. ER~ 9. CL EARANCE ____ _ CITY OF CARLSBAD 2075 Las Pa!mas Dr., Carlsbad, CA 92009 (619) 438-1161 FOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK NO. q70 6?. \ CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (619) 438-1161 EST. VAL. _________ _ Plan Ck. Deposit -----n'"'t-""T"-- Validated Oate. __ ......,"'"f'-+--+1--e---,'------ Subdivision Name/Number Phase No. Total I of units Assessor's Parcel I Proposed Use I of Bedrooms # of Bathrooms '°:.N_a_m/:.e::'.:":::.t:.~~::::..._/.'.µ.::..!~!,,d.~¥----"-A~d.J.d+r'-e.J.ss-=---114==:L.J.==---=-~,tA->---;;C;::it""y""'"'==-...__.~~::-;:;;:---"=~;:;-:~~':.L:;-'=....,....,..'---- ~ow;z;~-~TifBi?J'lliT~ Name Address City State/Zip Telephone I 6~~8~-colll! (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file e signed statement that he is licensed pursuant to the provisions of the Contrector's License Law (Chapter 9, commanding with Section 7000 of Division 3 of the Business and Professions Code] or that he 1$ exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($5001). Name Address City State/Zip T 11l11phon11 II State License # _________ _ License Class _________ _ City Business License I _______ _ Designer Name Address City State/Zip Telephone State License # ----------:-:- i;tk-WARICEJisl;COMPEN.,$4 TtON.l~~~~~~A~~~~~~~~cr~~L·:_~ .... ,~z~t~,b-.:-.~~;l.t.ot$~~'i~:~•arsR5 dt®aM~..rt,;~;~;li~~-·..,,~· ..... ;.~t~"~ Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: D I have and will maintain a certificate of consent to self-Insure for workers' compensation IS provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. D I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for :which this permit is issued. My worker's compensation insurance carrier and policy number are: · Insurance Company _____________________ Policy No. Expirat ion Date. _______ _ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS) 0 CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is iuued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to secure• woriter■' compen■ation coverage ii unlawful, and shall aubj•ct an employer to c:rlmklal penaltiu and c:lvll fines up to one hundred thouund doUers ($100,000), in addition to the coat of compenaation, damages•• provided for In Section 3706 of the Labcar code. lnter11t and ■ttomey'1 fees. SIGNATURE. _______________________________ DATE _________ _ :,_. ', •. OWNER-BUILDER DECLARATION,·-~-; o , ·• 1.-· "\\': : ••• , • . •• , .i .. ;r-::.~1~~~,~~~~,?~~¢:°.;::Jh'... ' i-h~~ attirm that I am exempt from the Contractor's License Law for the following reason: (l1 I, as owner of the property or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that 1uch improvements are not Intended or offered for ■ale. If, however, the building or improvement is sold within one yHr of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpo■e of aal•l- 0 I, ■s owner of the property, am exclu■ively contracting with licensed contractors to construct the project (Sec. 7044, Bu■inNa and Prof Ha Ions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and contract■ for such project■ with contractor(a) licen■ed pursuant to the Contractor's Ucensa Law). D I am exempt under Section ______ Bu■iness and Professions Code for this reason: / ally plan to provide the major labor and materials for construction of the proposed property improvement. 0YES ONO I (have / h ve hot) signed an application for a building permit for the proposed work. contracted with the following person (firm) to provide the proposed construction (include name / addrNS / phone number / contractors license number): 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name / address / phone number / contractors license number):. ______________________________________________ _ 5. I will provide some of the work, b t ired) the following persons to provide the work indicated (include name / address / phone number / type of work):. ______ <::"--.,;::-:-,a.-9----""7--r-r----:,-;----:;,";-:f----r-7''-:-----------::;-;~"7"--::;;----------- PROPERTY OWNER SIGNAT ~~nus:sEc1:1ott DATE Is th,i e;,plic::it er future buildir.v ccupant requ.r,o.:I t~ 6ubmit • butiineu µIan, acutaiy haz■rdou■ materials registration form or ri■k management and prevention program under Sections 25506, 5533 or 25534 of the Presley-Tanner Hazardou■ Substance Account Act? D YES O NO · Is the applicant or future building occupant required to obtain I permit from the air pollution control district or air quality management district? D YES O NO Is the facility to be constructed within 1,000 fNt of the outer boundary of I school site 7 D YES D NO IF ANY OF THE ANSWERS ARE YES, A ANAL CERTIACATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. ~(~_~STRUCTION LENDING"AGENCY '\...,·,~1}~~.'.J~~• ·<.'.'.':'.:.t¾l.\/ '.'~·~:':'.";~~~~~~~•t".:;:::}:. I hereby affirm that there is a construction lending agency for the performance of the work for which this permit i■ i■sued (Sec. 3097(1) Civil Code). ~.·.~ ~· . : -•, ·.i:..~ LENDER'S NAME ______________ _ 19: APPLICANT CERTIFICATION I certify that I have read the application and state that the above information is correct and that the information on the plans is accurate. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representatives of the City of Carlsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structur11 over 3 stories in height. EXPIRATION: Every permit issued by the Building Official under the provisions of this Code shall expire by limitation and become null and void if the building or work authorized by such permit is t commenced hin 365 days from the date of such permit or if the building or work authoriz by such permit is suspended or abandoned at any time after n d for~ perio of 180 days (Section 106.4.4 Uniform Building Code). DATE ___ __,.,.... ...... _f-------- YELLOW: Applicant PINK: Finance CITY OF CARLSBAD INSPECTION REQUEST PERMIT# CB970621 FOR 03/28/97 DESCRIPTION: INSTALL FAN, ELECT FIXTURES TYPE: MISC INSPECTOR AREA PK PLANCK# CB970621 OCC GRP CONS TR NEW STE: 226 OT: JOB ADDRESS: 2344 HOSP WY APPLICANT: ELKOR REALTY CONTRACTOR: PHONE: 312 669-1200 OWNER: REMARKS: PER INSP OF 3/25/97 SPECIAL INSTRUCT: TOTAL TIME: --RELATED PERMITS-- LVL DESCRIPTION PERMIT# TYPE CB920454 MISC CD 39 EL Final Electrical PHONE: PHONE: INSPECTOR _.:,Z::.::!:::=~=~---- STATUS EXPIRED ***** INSPECTION HISTORY***** DATE DESCRIPTION 032597 Final Electrical ACT INSP AP PK COMMENTS OK TO RELEASE/NOT FINAL